Individual provider Active NPI

Sean-Patrick Russell

  • Certified Registered Nurse Anesthetist
  • Lauderhill, FL
National Provider Identifier
1265054357
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11019891 Issued in FL
Practice address
5658 NW 16TH St
Lauderhill, FL 33313-5448
Phone
(954) 554-0286
NPI assigned
May 11, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN9436906 FL
Certified Registered Nurse Anesthetist 367500000X APRN11019891 FL Primary

Addresses

Primary practice location

5658 NW 16TH St
Lauderhill, FL 33313-5448

Mailing address

5658 NW 16TH St
Lauderhill, FL 33313-5448
Phone (954) 554-0286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220726001479 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486035276 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medicine Services of FL LLCGroup PAC ID 9537524343, 166 clinicians
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians
Miami Beach Anesthesiology Associates IncGroup PAC ID 6103713243, 61 clinicians

Practice addresses (Care Compare)

1700 S 23Rd St
Lawnwood Regional Medical Center
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

4300 Alton Rd
Miami, FL 33140-2948
Phone (888) 851-4642

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9436906FLMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medicine Services of FL, LLC CurrentSince Nov 21, 2024 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 20, 2025 Accepting new patients
Miami Beach Anesthesiology Associates Inc CurrentSince Jun 27, 2022 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

6700 Lake Nona Blvd
Orlando, FL 32827
Phone (689) 216-8000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1265054357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5658 NW 16TH ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333135448",
            "telephone_number": "954-554-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5658 NW 16TH ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333135448",
            "telephone_number": "954-554-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SEAN-PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-11",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9436906",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11019891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.